This executive order could have great human rights and ethics implications. South Africa is an example of a country that stands to be adversely affected. The country bears the world’s largest burden of HIV and is a major recipient of US federal funding.10 The country’s constitution enshrines the right to reproductive decision-making and the right to health,11 while its laws on termination of pregnancy places a legal obligation on health-care providers to provide or refer abortion-seekers to relevant facilities, when qualifying criteria are met.12 Compliance with Trump’s order will potentially require clinicians in NGOs and international agencies that operate in South Africa and receive US federal funding to violate their professional codes of ethics,13 the country’s abortion laws, and the country’s bill of rights.

The proposed indicator domains are heterogeneous: some reflect outcomes (greenhouse gas emissions or health), whereas others reflect process indicators with both direct and indirect links to climate change. Additionally, some can be modelled at a global or national level, whereas others reflect location-specific issues and would depend on data collection at sentinel sites.

5: Political and broader engagement5.1 Public engagement with health and climate change5.2 Academic publications on health and climate change5.3 Inclusion of health and climate change within medical and public health curricula5.4 Health and climate change in high-level statements of the UNFCCC and UNGA5.5 Implementation and estimated health benefits of the nationally determined contributions (NDCs)

Every year, more than 2 million women worldwide are diagnosed with breast or cervical cancer, yet where a woman lives, her socioeconomic status, and agency largely determines whether she will develop one of these cancers and will ultimately survive. In regions with scarce resources, fragile or fragmented health systems, cancer contributes to the cycle of poverty. Proven and cost-effective interventions are available for both these common cancers, yet for so many women access to these is beyond reach.

Whether or not the UN projection proves exaggerated (other studies suggest that it might be5), the standard policy prescriptions in developed countries have clearly not proved universally effective. African researchers are well placed to research the drivers of fertility and to test the effectiveness of population policies on the ground. Efforts to maximise the benefits of population change and reduce negative consequences are likely to be more successful if led by Africans.

The face of Zika is not often seen in the air-conditioned shopping malls of upscale Rio neighbourhoods or on the beaches of Ipanema. Rio has its fair share of cases, but so far the heaviest burden has been borne by the northeast region of Brazil, where poverty, poor infrastructure, and lack of access to health services are rampant, and the penetration of Aedes aegypti is high. A large proportion of the population in that region is of African descent—indeed, the face of Zika is often that of a darker-skinned person. And because most cases are asymptomatic, and the most dramatic signs of the disease appear through congenital Zika syndrome, the face of Zika is that of a woman or a small child.(...) poor women in Brazil, Colombia, El Salvador, and elsewhere have been let down by their governments. They are at the centre of the epidemics, they are scrutinised and lectured, but lack of access to basic reproductive services and restrictive abortion laws have stripped them of a choice when faced with the dire consequences of the virus on their health and that of their children.

Despite the pressing need for solutions to the rapidly expanding Zika virus transmission, in our opinion it is hard to posit a substantial role for either approach until direct evidence shows a reduced human disease burden.4 While we acknowledge that to hold novel or experimental techniques to unrealistically high standards is counterproductive, it is surely uncontroversial to suggest that diverse and credible data must be publicly available before resources and attention are diverted away from current control programmes.

An important aspect of the conceptual transformations is that the term sustainability has gradually changed from being a goal (durability) to acquiring connotations that serve as a selection criterion for development aid. Using sustainability as a selection criterion risks privileging recipients who have the capacity to gain control over health and living conditions and exclude others as unworthy needy.

We found a large causal effect of upper secondary schooling on HIV infection, but no association with primary schooling. In a natural experiment in Zimbabwe, secondary schooling led to delayed sexual debut, delayed fertility, and reduced child mortality.6 There is mounting evidence of health returns at the secondary level.

Many mathematical models have been developed to project the epidemiological and demographic effects of antiretroviral therapy (ART) on HIV epidemics and assess different policy options for the use of ART across sub-Saharan Africa and elsewhere. However, testing of these predictions against external data had not been possible. With new data from a nationally representative household survey in South Africa, we have, for the first time, compared existing model projections with data about HIV prevalence, HIV incidence, and ART coverage.

(...)

Implications of all the available evidence

Our results suggest that existing projections for reductions in HIV incidence after the scale-up of ART might have been overly optimistic. Resources needed for future HIV treatment and prevention are probably greater than previously forecast.

Deaths from acute abdominal conditions, and likely other surgical emergencies, are strongly related to geographical access to well-resourced surgical facilities. About two-thirds of deaths from acute abdominal conditions in India could be averted by improving human and physical resources at existing district hospitals.

The recommendation for having a highly resourced district hospital within every 50 km for a country spread over 3 287 590 km2 with a population of 1·252 billion might not be immediately feasible, but does help set aspirational targets for India. Global surgery has got off to a delayed start, but basic life-saving surgery is now an accepted public health measure worthy of political attention.

The pollutant is called social disadvantage and it has profound effects on developing brains and limits children’s intellectual and social development. Note, the pollutant is not only poverty, but also social disadvantage. There is a clear social gradient in intellectual, social, and emotional development—the higher the social position of families the more do children flourish and the better they score on all development measures.

Women should not feel bullied or emotionally blackmailed into breastfeeding by one over-zealous section of society any more than they should be made to feel ashamed for breastfeeding in public by another. Breastmilk provided exclusively for at least 6 months is unequivocally the best nutrition a baby can receive; women and their families need respectful advice to make the choice wherever that is possible.

Several factors hinder the acquisition of attention and resources for #global_surgery. With respect to actor power, the global surgery community is fragmented, does not have unifying leadership, and is missing guiding institutions. Regarding ideas, community members disagree on how to address and publicly position the problem. With respect to political contexts, the community has made insufficient efforts to capitalise on political opportunities such as the Millennium Development Goals. Regarding issue characteristics, data on the burden of surgical diseases are limited and public misperceptions surrounding the cost and complexity of surgery are widespread. However, the community has several strengths that portend well for the acquisition of political support. These include the existence of networks deeply committed to the cause, the potential to link with global health priorities, and emerging research on the cost-effectiveness of some procedures.